Billing and Insurance

Billing

University Health Services (UHS) bills for all clinical services offered at the University of Southern Maine. Students who seek care with our offices will be asked to provide UHS with a copy of their health insurance card. The insurance plan will be billed for each clinical appointment. Students without insurance will be billed directly to their address as listed in MaineStreet. Students without insurance will never be denied services for inability to pay for services. UHS offers a reduced payment or free care option for those who qualify.

UHS does not accept payment at the time of service. Insurance plans will be billed by our third-party billing agent, Physician Billing & Consulting, Inc (PBC). Any co-pays, co-insurance, or other fees not covered by the insurance plan will be billed to the patient. PBC will send the student a bill to the address listed in MaineStreet. Explanation of Benefits (EOBs) will be sent by the insurance company to the address on file with the insurance company*.

UHS encourages students to verify coverage with their insurance company before scheduling an appointment in our office. Students can call the member services number found on the back of their insurance card to inquire:

1. If UHS is in-network for the specific insurance plan
2. If there is a co-pay or co-insurance associated with care
3. Expected additional costs associated with care
4. If UHS is not in-network, where might they can seek care that is covered?

*Privacy concerns? Changes to the EOB address need to be made with the insurance company directly by calling member services. The address may be changed even if the student is not the policyholder.

Insurance

UHS is in-network with the following 3rd party payors:

* Our Clinicians are also enrolled with other payors such as Tri-Care and GEHA, however, coverage by these payors may vary or be subject to Out-of-Network coverage

As benefit policies can vary (even within the same 3rd party payor organization), we strongly recommend ALL students contact their insurance company to verify coverage for services in our offices.

* Not a comprehensive list of insurance providers accepted at University Health Services

Providing Insurance to Health Services

Students can upload their insurance to the student Health Record prior to coming in for an appointment. Students are also asked to bring their insurance card with them to their appointment for verification. Access the Health Record by following the below steps

1. Login to myusm.maine.edu
2. Click the accordion option USM QUICK LINKS
3. Click HEALTH RECORD

To upload your insurance card:

1. click the insurance tab 
2. Click ADD NEW
3. Enter the insurance company information, policy number, and group number, if applicable
4. Upload an image of the front of the insurance card
5. Upload an image of the back of the insurance card
6. Policy holder information is not required, but can be entered at your discretion.
7. Click ADD

Billing Process

The three steps to billing for services:

1. Contact your insurance company before you book your appointment. Confirm your coverage and ask about all costs expected based on your plan.
2. Book your appointment. Don’t forget to upload your insurance to the patient portal and bring it with you to your appointment.
3. Pay your bill. All costs not covered by the insurance plan will be billed to the address in MaineStreet. Follow the directions on the bill for payment.

Medicaid

Students with Medicaid should check with their insurance provider if it covers them for services outside of their home state. Oftentimes, Medicaid will only cover emergency services rendered to the policy holder outside of the home state. Even if UHS is contracted with a specific state, your plan may not cover certain services. Always contact member services if you have questions about coverage before scheduling an appointment.

UHS is currently contracted with the following states:

1. Maine

International Insurance

International plans will only be billed directly if there is a US-based address for billing on the insurance card. If the billing address is out of the country, the bill for services will be sent directly to the student (who is responsible for payment but can submit to their insurance plan for reimbursement as applicable to the plan).

Paying for Services

Students will not be expected to pay for services up front. After the visit is billed to insurance, any remaining balance (co-pays, co-insurance, uncovered costs, etc) will go to the student’s address on file in MaineStreet. The bill will list ways for the student to pay their bill via cash or check.

Students wishing to pay via debit/credit card will have to access TouchNet and pay online. TouchNet at USM currently takes Visa, Mastercard, or Discover. You will need the bill with you when you make your payment as you will be prompted for the invoice number and amount you will be paying. Follow the prompts throughout the process. Those wishing to utilize their FSA/HSA account will need to pay upfront with another method of payment and submit for reimbursement from their FSA/HSA.

Self-pay and reduced-cost care students will receive a bill for the costs for which they are responsible. Use the same payment options as above.

Questions about the bill should be directed to the telephone number printed near the top of the bill. Questions about coverage or lack of coverage should be directed to the insurance company directly. Any other questions can be directed to UHS.